Individual provider · Type 1 NPI

Miranda Loren Jackson, DNP

Nurse Practitioner · Pensacola, FL

NPI number 1104609619 Active

Practice location

9400 University Pkwy Ste 210
Pensacola, FL 32514-5485

Fax (850) 208-6369

Mailing address

PO Box 95590
South Jordan, UT 84095-0590

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X11026888 (FL)
Nurse Practitioner Primary 363L00000XAPRN11026888 (FL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104609619

Miranda Loren Jackson, DNP's National Provider Identifier is 1104609619, issued on Aug 17, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Pensacola, FL. The record was last updated on Feb 25, 2026.